Abstract:
Incretin hormones potentiate the glucose-induced insulin secretion following enteral nutrient intake. The best characterised incretin hormones are glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) which are produced in and secreted from the gut in response to nutrient ingestion. The property of incretins to enhance endogenous insulin secretion only at elevated blood glucose levels makes them interesting therapeutics for type 2 diabetes mellitus with a better safety profile than exogenous insulin. While incretin therapeutics (especially GLP-1 agonists, and more recently also GLP-1 / GIP dual agonists and other drugs that influence the incretin metabolism (e.g., dipeptidyl peptidase-4 (DPP-4) inhibitors)) are already widely used treatment options for human type 2 diabetes, these drugs are not yet approved for the therapy of feline diabetes mellitus. This review provides an introduction to incretins and feline diabetes mellitus in general and summarises the current study situation on incretins as therapeutics for feline diabetes mellitus to assess their possible future potential in feline medicine. Studies to date on the use of GLP-1 receptor agonists (GLP-1RA) in healthy cats largely confirm their insulinotropic effect known from other species. In diabetic cats, GLP-1RAs appear to significantly reduce glycaemic variability (GV, an indicator for the quality of glycaemic control), which is important for the management of the disease and prevention of long-term complications. However, for widespread use in feline diabetes mellitus, further studies are required that include larger numbers of diabetic cats, and that consider and test a possible need for dose adjustments to overweight and diabetic cats. Also evaluation of the outcome of GLP-1RA monotherapy will be neceessary.
摘要:
肠促胰岛素激素增强肠内营养摄入后葡萄糖诱导的胰岛素分泌。最佳表征的肠降血糖素激素是胰高血糖素样肽-1(GLP-1)和葡萄糖依赖性促胰岛素多肽(GIP),它们响应于营养摄入而在肠道中产生并从肠道分泌。肠促胰岛素的特性仅在升高的血糖水平下增强内源性胰岛素分泌,这使它们成为2型糖尿病的有趣治疗剂,具有比外源性胰岛素更好的安全性。而肠促胰岛素治疗(尤其是GLP-1激动剂,以及最近的GLP-1/GIP双重激动剂和其他影响肠促胰岛素代谢的药物(例如,二肽基肽酶-4(DPP-4)抑制剂))已经是人类2型糖尿病的广泛使用的治疗选择,这些药物尚未被批准用于治疗猫糖尿病。这篇综述概述了肠降血糖素和猫糖尿病的一般情况,并总结了肠降血糖素作为猫糖尿病治疗剂的研究现状,以评估其在猫医学中的潜在潜力。迄今为止关于在健康猫中使用GLP-1受体激动剂(GLP-1RA)的研究在很大程度上证实了从其他物种已知的其促胰岛素作用。在糖尿病猫中,GLP-1RA似乎显著降低血糖变异性(GV,血糖控制质量的指标),这对于疾病的管理和长期并发症的预防很重要。然而,广泛用于猫糖尿病,需要进一步的研究,包括更多的糖尿病猫,并考虑和测试可能需要调整超重和糖尿病猫的剂量。还需要评估GLP-1RA单一疗法的结果。